Drive Through ER

The Drive Through  Emergency Room. An idea I discussed when it was first trialed back in fall 2009 during early stages of the Swine Flu Scare. After reading several articles discussing this trial, it seems that it worked smoothly enough, particularly would be good to break out during a pandemic, or even yearly flu epidemic. This would keep infectious people out of the crowded ED waiting room and speed through put times during a taxing period.

Bad Weather, and the razorbacks season in review

With a patch of bad weather coming through the area lately, the ER has been busy. Car accidents, of course, and slips and falls with broken hips, and broken everything else, and hypothermic bums, and hypothermic little old ladies. And of course fires, which are the worst, and even people getting killed trying to make fire, like the two different guys we have seen killed cutting firewood this winter. I am certainly not a global warming naysayer, but this is the coldest winter since at least 1977 in many parts of the world. It is the coldest it has been in Key West for 131 years! I like the cold sometimes, but this is causing a lot of anguish, and is having all kinds of unseen effects like driving up fuel prices, and may even contribute to another flu (swine or otherwise) outbreak by keeping everyone jammed together in doors. ... (By the way, sorry to use all these dots and wierd punctuations, but it seems you can't start a new paragraph and indent on here.)..... Anyway, I have been using some of my extra time inside to reflect on the razorbacks. I am happy with the bowl we got, and I think we beat a tough team, from a tougher than most think conference. I am not Happy with Mallett, though. He looks like Gumby trying to play football, and he thinks he could have even thought about going pro? I doubt it. But the thing I hate the most is here he is, after his "sophomore" year, wanting to go. We know he doesn't care about the team. We can see where his selfish thoughts lie, and we have to spend the whole next season knowing he is leaving us early, and wishing he could have done it sooner. Oh well, I do think we will have an awesome season next year, maybe we actually will be a contender in the west?

The Hiney shot

A patient told me today they had had a fever ever since they recieved the hiney shot. The hiney shot? I thought about this a second and realized they meant the H1N1 shot!

The ICU

Rotating in the ICU and, like roy basch, it is about to become the breaking point for me. Our patients die every day. From the 47 year old breast cancer, to the 34 yr old lung cancer patient, yes 34. The asphyxiated elderly man who layed two weeks brain dead because the family was too guilty to pull the plug, they all die. It is one big swarm of death. The only thing I haven't seen kill anybody yet in our ICU is the swine flu. Cade is taking it the hardest. I think he really thinks ghosts are following him around the hospital. He talks about them all the time. which ones might be present, and why. In the elevator he tries to decide if all the people he has killled can fit in there with him. He says they follow him down the halls at night, and bang on the door of his call room. He sees glimpses of them from the corners of his eyes. He is crazy. But......I would be scared too if I had stolen the big screen from the hospice house!

New Clue in Residency Lounge case

As hard as this may be to believe, I have stumbled onto an astonishing new clue in the lounge vandalism case. I went in, late last night, to use the restroom and heard voices and laughing from the back. When I looked further I found a few of the staff in there, with a complete hair cutting operation going on! I mean the entire bed had this big fancy kit spread out on it, the person getting their hair cut was on a stool, with a drape around their neck and everything looked super professional. There were hair cuttings all on the floor, which they assured me they would be vacuuming up after they finished. They also assured me they were all either off duty or on lunch break. I couldn't believe it! This could explain how the hair got in the drains, in fact I'm pretty sure it does. However, they asked me how the beds got broken, so they must not have been involved in that...or were they? Now the big question is should I mention this to anybody, at least just to convince them to change the locks or something. I would never reveal any names, because I like all these people, but to say the least, I was shocked. Note: The actual details and circumstances of this encounter were significantly altered for the purpose of this blog. The encounter actually occurred several weeks ago and I actually only heard about it second hand, rather than witness it myself. Remember, this blog in no way reflects actual occurrences, it simply tells a story about the residency experience. Again, as the disclaimer states, the reader would do better to spend his / her time looking into their own hearts and souls than to try to place real people to these fictional events. Do I make this point very clear? lol.

Residency candidates

Going out to dinner tonight with some residency candidates. The best I can say about this is it will be a free meal. We have really had some duds at times. Like the guy that kept telling me to check out the female candidates ass while on the tour of the hospital. And the guy who thought he was the next thing to god, and said that he left his wife at the hotel for dinner, because he didn't care what she thought. And so many more. It is really hard to believe what some people actually say and do.

Afghanistan

The afghan war dead total 55 so far this month, the deadliest since we entered the war in a place I can't even spell. On another note, the word for the day at work has been felching, or felcher. I don't even dare to define this word on this website....

Do I Have Swine Flu?

I have a fever, runny nose, myalgias, I feel like shit! Do I have the Swine Flu? I think so....lbut I don't have a cough or anything. Who knows.

Bad Luck

Just back from the Ozarks and a big weekend of trout fishing, during which I caught absolutely zero trout! At least my friend caught two good sized brooks and we had trout for dinner once anyway. Oh well. I am always bad luck when I fish.

Swine Flu

The number of swine flu deaths topped 1,000 on the year in the US today. Sounds scary? An average of 36, 000 die per year from seasonal flu related complications in this country. A high year since 92 has seen 56,000. So it isnt time to panic (oh, its too late for that, huh?). However, the traditional seasonal flu will likely also strike later this year, and bring many more deaths, particularly amongst the elderly, with it.

AAA

A 19 year old girl came to our ED today, complaining that she had a AAA (abdominal aortic aneurysm). She was smiling and laughing and said that she thinks it is ruptured. Her cousin, a nurse, had told her that she had a pulsating mass in her belly and that she needed checked out. She sent her with a list of tests that we should perform to diagnose the aneurysm. I was so glad. The girl certainly did not have an aneurysm, but I attempted to calmly reassure her. However she insisted and seemed terrified so I ordered a few of the desired tests. No aneurysm. Ridiculous.... She was kind of nice though, and I think her cousin the nurse had just really scared her.

Dental Residents

Allow me to start by saying I love my dentist. He is one of the most intelligent men I have had the privilege of speaking too. He has far more general medical knowledge than I. The only problem I have with him is that he always starts conversations that are dependent on me answering 100 questions while I have my mouth open wide and full of instruments. Anyway, the dental residents here at our hospital, I don't love quite so much. Today, they sent over a lady from the dental clinic because of bleeding gums. I mean minor bleeding gums. They requested that she be evaluated for a bleeding disorder. I did a CBC to check platelets and Hgb, and informed the pt that any further workup would need to be coordinated by her family doctor, because these are not the kind of things we do in the ER. She was unhappy and took it upon herself to page the dental resident from her room phone. The resident came down and chewed me out for 5 minutes. She wanted something done, and done know. She had intended for me to diagnose the problem, and send the pt back to complete her dental work, before the dental office closed at five. She wanted to know why her critical patient had set in the waiting room six hours before even being evaluated. This changed nothing that I planned to do, and it made it obvious how little she understood about medicine in general. I stayed calm, and attacked her instead with the use of big words like Idiopathic Thrombocytopenic purpura and diathesis. We parted on fairly good terms, and hopefully she has the point that we don't need her bogus referrals, particularly in the midst of the swine flu crises.

A new Name

Anshawnalakiesha. How about that to add to the collection of names?

Hogs Nearly pulll Major Upset

The season has already had its highs and lows for the hogs, but a superlative high nearly came yesterday with an upset of Florida. The hogs were thwarted at the last second by a field goal, to put the gators up 23-20. Oh well. Mallet played well anyway, and I am really starting to like this team.

Swine Flu

43 kids have died this year so far from swine flu, and it is not even time for "true flu season". In an average flu season only 50 die. That's for the entire year. As I have said, Hospitals that I know of personally are putting into action emergency plans for overflow tents. Is this thing going to be that bad? It is certainly going downhill right now.

Swine Flu

The Swine Flu is heating up. Where are those vaccines? Several people in our area have died, who I believe probably wouldn't have died from traditional seasonal flu. It seems like, when you look at our ED board, 75% of the complaints are fever, cough, flu-like symptoms, or exposure to flu, or positive flu test. All the pts wear masks, and things are crazy. wait times are through the roof. What will we do for room in the hospital if things get a little worse? Back to the vaccines, I guarantee these same people who rush thekids in for every little sniffle and demand testing and treatment for the swine flu are the same ones who will refuse the vaccine, and we will have to spend just as much time convincing them it is safe.

Swine Flu Strikes

The Swine Flu has hit our emergency department hard already and the flu season is very, very young. The Hospital is staying full and Holds are filling up the Emergency Room. The waiting room is a madhouse, people are in arguements, fist fights, and half the people are wearing masks. Things are very, very crazy!

Swine Flu

Do you realize there have been 595 swine flu deaths in the US already? Second only to Brazil. 2,000 cases have been reported on the campus of washington state alone. I heard on the news about an ER nurse who died recently as well....

Does the estimate of 90,000 deaths mean there will be that many in addition to the 60,000 who will die from the seasonal flu? certainly the people the flus will kill will overlap? I guess if the swine flu ONLY killed the young then it would be different than the ones who would die from seasonal flu, but it wont ONLY kill the young, right?

New Swine Flu Reports Trigger New Post

Recently released estimates say that the swine flu could infect half of all americans and kill as many as 90,000. The typical annual number from seasonal flu is about 60,000. Also The CDC dogedly stands by the statements that young people and children will be heavily affected.